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Connecting healthcare anchors and communities

Submitted by john on October 22nd, 2018

Our twice-annual Healthcare Anchor Network (HAN) convenings are largely designed as spaces for the over 35 member hospitals and health systems to roll up their sleeves and get to work building collaborative tools and strategies to advance the anchor mission. But we also like to take time to zoom out, put big questions on the table, and connect with social innovators and community leaders in our host city.

Learning from Healthcare Leaders

Our Spring 2018 convening in the Bay Area, co-hosted with Kaiser Permanente, Dignity Health, and UCSF, was no exception. One of the most powerful moments of our gathering was a public panel discussion of senior healthcare anchor leaders we organized in Richmond, California, where we had traveled to visit the site of an impressive new food system facility in development with the help of Healthcare Without Harm and the Emerald Cities Collaborative. In this panel, sitting in a converted shipbuilding warehouse on the same docks where America’s first integrated health system was born, we heard from five anchor leaders who have each made seminal contributions to the field, helping illuminate new possibilities for hospitals and health systems to deploy their operational resources to help tackle the economic determinants of health.

The key question for the panel’s moderator, Dr. David Ansell, (SVP at Rush University Medical Center, Chicago, and author of The Death Gap: How Inequality Kills) was what it means when an anchor “takes on health equity as one of [its] cornerstone strategies”: and how this commitment creates a moral imperative to align strategies both inside and outside the institution for the benefit of the community. For Michellene Davis, EVP and Chief Corporate Affairs Officer at RWJBarnabas Health in New Jersey, this shift happened when “we finally began to realize and understand as an institution” that the members of their community “cannot bewell when they are concerned about how to feed their children or where they are going to sleep tonight.”

Echoing this sense of deep commitment to community well-being, Bechara Choucair, Chief Community Health Officer and SVP at Kaiser Permanente, explained how “community health work is core to our business strategy and we invest every year over $2.8 billion in community health efforts across the country. [...] We’re always asking: Who are we hiring? How are we investing our treasury dollars? How are we procuring services? How are we building facilities? And that becomes core to who we are as an organization to improve community health.” Randy Oostra, CEO of Promedica in Toledo, Ohio, likewise outlined his own health system’s realization that if “we don’t do something to help these communities that are struggling, nobody’s going to. […] We have the financial resources, we have the people resources, and for us it was just a matter of trying to figure out how we can fit in and try to help others address the problem.” Pablo Bravo, Vice President of Community Health at Dignity Health, outlined a similar commitment to the anchor mission: “As an anchor institution, we do not get up and leave. We’re there and we’re going to make everything possible by using our assets to help the community succeed whether it’s through investing, whether it’s through hiring locally, or buying from the local producers.”

The vibrant discussion between the panelists addressed not only the need for and promise of the anchor mission approach, but also the key challenges to be overcome, including the need to center a racial equity analysis in order to truly address the social and economic determinants of health.

Watch the full panel:

See the highlights:

Engaging communities

The next day, we continued to explore the critical question around the relationship between community agency and public health with a panel of innovators working on health equity issues as organizers, social designers, and philanthropic leaders. Moderating the panel was Denise Fairchild, President and CEO of the Emerald Cities Collaborative, who framed the discussion around how to advance a “new notion of community engagement, which is called building epistemic communities.” For Fairchild, this “means having health institutions, having people of every social, racial, and ethnic group in a community come together and having a shared vision about a shared fate and a shared destiny, and bringing all their assets to the table, to create the social cohesion to move that community forward.”

The challenge inherent in this vision is that building this kind of authentic community engagement requires addressing the systemic imbalances in power between healthcare institutions and communities that have suffered from disinvestment. For Dr. Pritpal Tamber, CEO & Co-Founder of Bridging Health & Community, this points to a key strategic principle: “You’ve got to raise up the community to have a voice. Power should be the primary outcome that you look for.”

Dr. Tony Iton, SVP for Healthy Communities at The California Endowment concurred: “many communities that are struggling with health challenges have very little voice at [...] decision-making tables. So we think power and politics, small ‘p’, are absolutely critical.” Iton, who emphasized the need to move beyond a framework in which power is something to be fought over to something that is built together, collaboratively: “power is not a zero-sum game; [...] someone doesn’t have to lose in order for someone to win. There are really kind of efficiencies, democratic efficiencies, in getting as much voice involved in decision-making as much as possible. We’ve been essentially skewing input towards those with resources and privilege, and away from those who actually need these resources even more, and often times have more expertise about how we should prioritize the resources. So we do believe that the more people participate, the more collective power there is, and in many ways it’s unlimited.”